For many people, dealing with stress can be a bit… stressful. But that isn’t necessarily the case for Melissa Lippold, an assistant professor at the UNC School of Social Work, whose academic career thrives on the study of stress.
In fact, Lippold is among a growing group of researchers who are beginning to dig a little deeper into how relationships can affect physical health, including the development of diseases and stress-related physiology.
Much of her research centers on the relationships of parents and children and a desire to understand how those relationships affect health and well-being, a promising area of research that has gained the attention of the National Institutes of Health. In May, Lippold received one of the NIH’s highly competitive R03 grants and was awarded $152,000 to study how the relationship between parents and children fluctuates, especially during middle school years. The study will also explore how those changes potentially affect early adolescent substance use.
Most recently, Lippold co-authored an article published in the Journal of Research on Adolescence that examined “daily positive and negative experiences with parents” and how those might be linked to kids’ stress response systems and their physical health.
Lippold and her co-authors (Susan McHale, Kelly Davis, and David Almeida from Penn State and Rosalind King from the Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD]) used data from the NICHD-funded Work, Family, Health Study, which explored the amount of cortisol, also known as the “stress hormone,” that individuals produce every day over the course of a week. Generally, cortisol levels ebb and flow over the course of a day, rising during the morning hours before dropping to their lowest levels at night.
Research has shown that levels of cortisol are associated with, among other functions, blood sugar, blood pressure, and sleep. However, overall health becomes more of a concern when individuals, especially children, experience chronic stress and their cortisol levels remain high over prolonged periods of time, Lippold explained.
“One of the things we found was if a child had a negative experience with their parents and it wasn’t that common of an experience, those kids seem to recover and were OK the next day,” she said. “But some of these kids who had a lot of negative experiences—for example, their parents criticized them, or got angry with them or didn’t listen to them—if that was the norm, and these experiences happened often in their family, those kids and their stress response systems didn’t seem to recover even on days when it was less stressful than usual. So a day later, even when there wasn’t as many negative experiences, their stress response systems were still highly activated, and they had unhealthy patterns of cortisol.”
Years ago, adolescent anxiety and stress were more likely considered as just part of growing up. Today, researchers know that such experiences not only affect an individual’s physiology but as stress response systems become overworked, people are at an increased risk for immune problems, mental health issues such as depression, and diseases such as cancer and diabetes, Lippold said.
“It’s not clear exactly how stress is linked to disease, and how relationships can influence health, but the field is starting to try to unpack some of the processes, which is interesting,” she said. “Over time, as this research develops, we will understand what aspects of parenting matter for physical health and how to refine our interventions. Once you understand these processes and understand what happens, you’re in a much better position to try and think about how you can assess intervention effects on biological levels. How can family interventions affect stress and physical health?”
Lippold, who recently applied for a second NIH grant, hopes further study will tackle some of these questions and more, including how children also affect the health of their parents.
“We know from the literature that usually the arrow goes both ways—that parents affect children’s health and vice versa, but we just haven’t learned a lot about bidirectional influences on health,” she said. “There’s only been a handful of studies that looked at synchronization—how physiological responses between kids and parents might line up or sync up.”
All of these issues pose important considerations for social workers in direct practice and particularly for those working with children living in risky environments or in stressful families, Lippold added. Having worked closely with foster children and families early in her career, Lippold said she learned quickly that prevention is the key.
“I really became interested in prevention… after seeing how families can become entrenched in negative cycles, and how really hard it is to change these dynamics once they become entrenched,” she said.
Long-term, Lippold aims to better understand how such social problems develop before they become so rooted and are more difficult to treat.
“Even with these families that we’ve seen that are dealing with stress, these aren’t families that are typically high risk, but you can still see in some of them the beginning signs of a chronic stress response, which may have long-term negative health implications,” Lippold said. “So it’s important for social workers to continue to think about risk and protective factors for social problems and how we may be able to prevent some of these problems that we care about so much.”